title: Unplanned admission after day-case haemorrhoidectomy: a retrospective study.
abstract: OBJECTIVE
  To identify the risk factors associated with unplanned admission after day-case haemorrhoidectomy.
  
  
  METHODS
  This was a retrospective review of the outcomes of patients who underwent elective, intended day-case haemorrhoidectomy in a surgical institution between January 2005 and December 2009. Data were generated from a computerized database. Information on patient demographics, type of surgery, mode of anaesthesia, operative time, operation end time, and perioperative drugs were collected and analysed. Unplanned admission was carefully recorded.
  
  
  RESULTS
  In a 5-year period, 243 patients underwent intended day-case haemorrhoidectomy. Of these, 43 (17.7%) had unplanned admission, with acute urinary retention as the most common cause (n = 30). Using univariate analysis, male gender, the use of spinal anaesthesia, and a late operation end time of after 2 PM were found to be positive risk factors associated with unplanned admission, whereas the use of single-dose dexamethasone during induction was identified as having a negative effect on unplanned admission. However, multivariate analysis showed that only male gender, the use of spinal anaesthesia, and a late operation end time of after 2 PM were independent risk factors.
  
  
  CONCLUSIONS
  Good operation listing and the use of general anaesthesia are recommended in the practice of day-case haemorrhoidectomy.
authors.affiliation: Department of Anaesthesia, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong SAR.
authors.forename: Pik Yan
authors.initials: PY
authors.lastname: Chan
authors.forename: Monica Pik Lin
authors.initials: MP
authors.lastname: Lee
authors.forename: Hester Yui Shan
authors.initials: HY
authors.lastname: Cheung
authors.forename: Chi Chui
authors.initials: CC
authors.lastname: Chung
authors.forename: Michael Ka Wah
authors.initials: MK
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000775:Anesthesia, Spinal; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016055:Urinary Retention / Q000209:etiology